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Individual

AMY R. LALICK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DDS

Contact information

Practice address
285 JAMES ST, HOLLAND, MI 49424-1849
(616) 399-0200
(616) 738-9127
Mailing address
285 JAMES ST, HOLLAND, MI 49424-1849
(616) 399-0200
(616) 738-9127

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2901018065
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
4535594
MI
01
BC00473
BLUE CROSS BLUE SHEILD MI
MI
Enumeration date
06/13/2006
Last updated
07/16/2015
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